Conversion to Chronic Invasive Fungal Sinusitis From Allergic Fungal Sinusitis in Immunocompetence

Edelmayer, Luke; Ito, Christopher J.; Lee, Won Sok; Kimbrough, James C.; Kountakis, Stilianos E.; Byrd, J. Kenneth

doi:10.1002/lary.27884

Cited by 18 publications

(12 citation statements)

References 20 publications

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“…Seven patients were included, 4 from UTSW and 3 from the literature. [6][7][8] Demographic and clinical information is presented in Table 1. All patients were male.…”

Section: Resultsmentioning

confidence: 99%

Fungal sinusitis: a spectrum of disease

Ryan

Marple

et al. 2020

Int Forum Allergy Rhinol

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“…Seven patients were included, 4 from UTSW and 3 from the literature. [6][7][8] Demographic and clinical information is presented in Table 1. All patients were male.…”

Section: Resultsmentioning

confidence: 99%

Fungal sinusitis: a spectrum of disease

Ryan

Marple

et al. 2020

Int Forum Allergy Rhinol

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“…It includes patients having the following characteristics: All patients must have the relevant criteria in the Guidelines for Diagnosis and Treatment of Chronic Sinusitis in China [ 6 ] The patients' ages ranged from 20 to 60 years old This research was accepted by the hospital ethics committee. The patient's families were informed about purpose and process of the study.…”

Section: Methodsmentioning

confidence: 99%

Treatment and Impacts of Chronic Sinusitis with the Confluence of Biyuan Tongqiao Granules and Saline Nasal Irrigation

Liu

2022

Journal of Healthcare Engineering

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In this research study, we will study the clinical effect of Biyuan Tongqiao granules with saline nasal irrigation for treatment of chronic sinusitis. It will also study its impacts on the computed tomography (CT) score of the nasal sinus and negative reactions in patients. For this purpose, ninety (90) patients with chronic sinusitis were admitted to the hospital (June 2019 to June 2020). They were selected as the research subjects and divided into experimental and control groups randomly with 45 cases in each group. Control group patients were treated with nasal irrigation with normal saline. While, Biyuan Tongqiao granules combined with nasal irrigation with normal saline was treated by the experimental group. The CT scores of nasal sinus, clinical effect, the incidence of adverse reactions, recurrence rate, duration of nasal mucosal epithelialization, and nasal ciliary transmission speed of both the groups were compared. The patients’ pain was assessed by the visual analogue scale (VAS), and the symptoms of sinusitis were scored by the SNOT-20 scale. The experimental group showed significantly lower sinus CT scores and better clinical effects. Adverse reactions were not observed in both the groups’ probability ( P > 0.05 ). The experimental group presented a significantly lower recurrence rate, shorter duration of nasal mucosal epithelialization, faster nasal ciliary transmission, and sharply lowers VAS scores and SNOT-20 scores than in the control group ( P < 0.05 ). This proves Biyuan Tongqiao granules and nasal irrigation with normal saline can effectually boost the clinical efficacy and lessen the computed tomography score of nasal sinus in chronic sinusitis patients. It has a worthy clinical application and promotion.

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“…Two separate case reports have presented immunocompetent patients with AFRS who subsequently developed invasive fungal disease, either in the form of acute invasive fungal sinusitis 7 or chronic granulomatous invasive fungal sinusitis. 8 Although histology from the case presented herein did not reveal angioinvasion, necrosis, or granulomatous changes, these are distinct possibilities, especially given the clinical improvement on an antifungal treatment regimen usually reserved for invasive fungal disease.…”

Section: Discussionmentioning

confidence: 70%

Allergic Fungal Sinusitis Imitating an Aggressive Skull Base Lesion in the Setting of Pembrolizumab Immunotherapy

Krane

Beswick

Sauer

et al. 2020

Ann Otol Rhinol Laryngol

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Objectives: We report a case of acutely worsening allergic fungal sinusitis in a patient receiving immunotherapy with pembrolizumab, a programmed cell death protein 1 (PD-1) inhibitor. Methods: A 53-year-old man with a history of metastatic melanoma and recent initiation of pembrolizumab therapy presented with acutely worsening headaches, left abducens nerve palsy, and neuroimaging demonstrating an erosive skull base lesion with bilateral cavernous sinus involvement. Results: Intraoperative findings were consistent with non-invasive allergic fungal sinus disease. Microbiology and histopathologic data ruled out malignancy and demonstrated Aspergillus fumigatus without concern for angioinvasion. After treatment with antifungal therapy, the patient’s symptoms and abducens nerve palsy resolved. Symptoms were well-controlled 7 months after his initial presentation. Conclusions: Inflammatory sinusitis in patients receiving anti-PD-1 therapy may be secondary to T-cell infiltration, a similar pathophysiology as immune-related adverse events, and warrants appreciation by otolaryngologists given our increasing exposure to immunotherapy and its head and neck manifestations.

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Conversion to Chronic Invasive Fungal Sinusitis From Allergic Fungal Sinusitis in Immunocompetence

Cited by 18 publications

References 20 publications

Fungal sinusitis: a spectrum of disease

Fungal sinusitis: a spectrum of disease

Treatment and Impacts of Chronic Sinusitis with the Confluence of Biyuan Tongqiao Granules and Saline Nasal Irrigation

Allergic Fungal Sinusitis Imitating an Aggressive Skull Base Lesion in the Setting of Pembrolizumab Immunotherapy

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